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Biomedical subjects

G Creatsas

Publications and source records attributed to G Creatsas.

At least 127 records · Page 7Linked to original sources
PubMed1997

Contraception and sexually transmitted diseases.

The needs for contraception are increasing world-wide as more women desire protection from unwanted pregnancies. Since the incidence of sexually transmitted diseases (STDs) has increased in many countries, consultation for contraception should be provided together with that on STDs. Each woman may choose the contraceptive method according to her needs but she should also be informed about the beneficial and negative effects of the method in preventing STDs.

Causality↗
PubMed1997

Adolescent laparoscopy.

Laparoscopy is a useful and safe diagnostic procedure that provides excellent visualization of the pelvic structures and often permits the diagnosis of gynecologic disorders and pelvic surgery without laparotomy. During the period 1994-1996 40 laparoscopies were performed as a diagnostic procedure on adolescents aged between 14-19 years. In 21 cases of primary amenorrhea the laparoscopy showed 12 cases of Rokitanski-Kuster-Hauser syndrome (57.2%), hematocolpos-hematometra 4 (19.0%), polycystic ovarian disease 2 (9.5%), late onset of puberty 2 (9.5%) and gonadal dysgenesis 1 (4.8%). Laparoscopy which was performed in 12 cases of pelvic pain showed 6 with normal genitalia (50%), endometriosis in 2 (16.7%, infection in 2 (16.7%), fibroma in 1 (8.3%) and torsion in 1 (8.3%). Four laparoscopies were performed for ovarian mass; three cystic masses and one case of endometriosis were detected.

Adolescent↗
PubMed1996

A multicenter European survey of the attitudes to contraception in women at high risk or with established cardiovascular disease.

OBJECTIVES: The survey was designed to study the attitudes of gynecologists from 11 European centers providing guidance in contraception to women at high risk and women with cardiovascular disease. METHODS: Attitudes were registered by means of a standard questionnaire. RESULTS: Most contributors reported that, in women with venous thrombosis (10/11), deep venous thrombosis (10/11), coagulation disorders (11/11) and stroke (8/11), they prefer to prescribe methods other than combined oral contraceptives (COCs). A history of myocardial infarction was considered a relative contraindication and some experts suggested that, in some cases, the use of third-generation COCs may be possible. COCs were not recommended in women with severe cardiovascular disease and in those over 35 years of age with light or moderate cardiovascular disease, heavy smokers (over 20 cigarettes per day), or those presenting with severe hyperlipidemia. CONCLUSION: The pill is not considered appropriate for women with clinically established cardiovascular diseases or in cases where more than two coronary risk factors exist. COCs may safely be given to women with elevated blood pressure as long as it is lower than 160/100 mmHg, in cases of light and moderate cardiovascular disease as long as the patient is less than 35 years of age, in women who are not heavy smokers, in the presence of a light or moderate degree of hyperlipidemia, and in uncomplicated diabetes mellitus provided that there are no additional risk factors. In these cases, third-generation COCs are preferred. The co-operation of the cardiologist is desirable in order to classify cardiovascular disease and for patient follow-up.

Adult↗
PubMed1995

Adolescent gynecology and obstetrics.

Adolescent gynecology is a subspeciality of obstetrics and gynecology and not broadly known. It deals with many gynecological and obstetrical problems which may be seen during adolescence. The International Federation of Pediatric and Adolescent Gynecology is a branch of FIGO and promotes research and teaching programs on pediatric and adolescent gynecology. Health care professionals should address sex education programs providing accurate information to young people on sexual matters. Prevention of gynecological diseases, undesired pregnancies and sexually transmitted diseases are the goals of physicians working in adolescent gynecology.

Adolescent↗
PubMed1995

European Society of Contraception oral contraceptives survey update: birth control methods in "Europe of the 12".

The European Society of Contraception developed a survey to examine birth control methods in the 12 countries++ of the European Community. Responses to those questions relating to prescribing++ practices of oral contraceptives (OCs) are presented herein. The survey was sent to 400 physicians. One hundred two responded, most from France, Belgium, and the United Kingdom. The responses revealed that the most popular OCs are modern combined formulations containing low doses of ethinyl estradiol and progestogens such as norgestimate, desogestrel, gestodene, and levonorgestrel. More than half of physicians prescribe a particular formulation because of its tolerability and 20% because of its hormonal content. More than 90% prescribe OCs to healthy, nonsmoking women over 40. However, three fourths will not prescribe OCs to smokers over 35. Half of physicians recommend mammography for their older OC patients. Half also recommend cholesterol screening, but 8% only for women over 30. Most physicians are no longer reluctant to prescribe OCs to their diabetic patients: 61% prescribe OCs for women with non-insulin-dependent diabetes, 56% for those with insulin-dependent diabetes, and 85% for those with a history of gestational diabetes. Despite recent studies showing no relation between past OC use and cardiovascular disease, 42% of physicians said that their greatest OC-related health concern is cardiovascular disease. One third cited noncompliance as their greatest concern. These results reveal inhomogeneous prescribing practices for OCs among European physicians. ¿Over-screening¿--not prescribing the pill because of perceived (but not necessarily real) health risks--may be depriving many women of the contraceptive and noncontraceptive benefits of OCs. Complete and accurate information--as promoted by the European Society of Contraception--is one way to combat such overscreening.

Adult↗
PubMed1994

High-grade endometrial stromal sarcoma in a 16-year-old girl.

Endometrial stromal sarcoma (ESS) is a rare uterine malignancy with a variety of morphologic characteristics and clinical courses. We describe a case of high-grade malignant ESS in an adolescent girl, arising in a rudimentary uterine horn and presenting symptoms of an acute abdomen. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy due to a stage IVA high-grade ESS. An adjuvant chemotherapy and radiotherapy treatment was recommended, but 10 days after her discharge the condition of the patient deteriorated, with diffused metastases into the lungs and the abdomen, and finally she succumbed to the disease 1 month after her first admission to the hospital.

Abdomen, Acute↗
PubMed1994

Transdermal estradiol plus oral medroxyprogesterone acetate replacement therapy in primary amenorrheic adolescents. Clinical, hormonal and metabolic aspects.

Twelve primary amenorrheic adolescents were treated with transdermal estradiol 100 micrograms (Estraderm TTS-100 (R)) twice weekly for 3 weeks, plus MPA 10 mg per os daily (Provera) for the last 11 days, following an interval of 1 week. A basic examination and a re-examination at 6- and 12-month intervals were carried out for clinical evaluation, hormonal assays, lipid, carbohydrate and bone metabolism. No significant changes were recorded on the FSH, LH, 17 beta-estradiol and PRL serum levels. A significant decrease of TC values and atheromatic indices 1 (TC/HDL) and 2 (LDL/HDL) was seen (P < 0.05) at the end of treatment. On the other hand a significant increase in apolipoproteins A1 was found. A beneficial effect was also recorded on the bone mass. Finally, no significant side-effects were reported. It is concluded that this kind of hormone replacement therapy is efficient and safe for the treatment of amenorrheic adolescents due to gonadal dysgenesis.

Administration, Cutaneous↗
PubMed1993

A preliminary trial of human zygote culture in Ham's F-10 without hypoxanthine.

PURPOSE: This study deals with the suitability of Ham's F-10 without hypoxanthine for early cleavage-stage embryo culture. A high percentage of mouse two-cell embryos developed into morula and blastocysts in Ham's F-10 formulated without hypoxanthine (75.3 and 71.6%, respectively); in contrast, in agreement with previous reports, only 15.4% developed beyond the two-cell stage in Ham's F-10 with hypoxanthine. To begin to evaluate the effect of hypoxanthine on human embryos, a total of 318 human oocytes was fertilized and cultured in Ham's F-10 minus hypoxanthine. RESULTS: The fertilization, cleavage, and pregnancy percentages in two ovulation induction protocols [human menopausal gonadotropin (hMG)/human chorionic gonadotropin (hCG) and gonadotropin releasing hormone/hMG/hCG] were 82, 88, and 20 and 83, 91, and 30%, respectively. CONCLUSION: These results suggest that, in agreement with mouse embryo development, hypoxanthine does not appear to be necessary for human embryo cleavage and its omission from Ham's F-10 may enhance the conditions for culture of early-cleaving human embryos. These observations may lead to a better understanding of critical cell processes during early human embryonic development.

Adult↗
PubMed1993

Immediate postplacental insertion and fixation of the CuFix postpartum implant system.

Since promising results were obtained with the CuFix interval implant system in international clinical trials conducted worldwide, a modification of the device adapting it for immediate postplacental insertion and fixation (IPPIF) seemed a logical approach to solve the expulsion problem of IUDs inserted at that particular time. Seventy-three insertions were performed at three university centers, during 1990 and 1991, both by skilled and unskilled investigators. The results of this multicenter study show the excellent retainability of the modified IUD supporting the validity of the anchoring principle. The insertion procedure is easy, requiring minimal training, and the insertion technique appeared to be safe.

Equipment Design↗
PubMed1993

Treatment of polycystic ovarian disease during adolescence with ethinylestradiol/cyproterone acetate versus a D-Tr-6-LHRH analog.

OBJECTIVE: This study was undertaken to compare the clinical and endocrinological results of two kinds of treatment on adolescents with polycystic ovarian disease (PCOD). METHOD: Forty-five adolescents with PCOD were randomly allocated into two groups, treated either with ethinylestradiol (EE)/cyproterone acetate (group A) or the GnRH analog D-Tr-6-LHRH (group B). RESULT: No significant changes were detected on the body mass index and waist-hip circumference. A significant improvement of hirsutism was noticed in both groups of patients. A normal menstrual period was recorded in group A adolescents while all group B patients became amenorrheic. A favorable decrease of ovarian volume was detected in both groups. LH/FSH ratio and delta 4-androstenedione serum levels were found significantly reduced in both groups in comparison to pre-treatment levels. The comparison between the two groups, after 6 months, showed significantly lower values of LH/FSH ratio in group B cases. CONCLUSION: Both forms of treatment are safe and effective to a various degree for the management of PCOD adolescents.

Adolescent↗
PubMed1993

Spermicidal and antiviral properties of cholic acid: contraceptive efficacy of a new vaginal sponge (Protectaid) containing sodium cholate.

Cholic acid (sodium cholate) exhibits a strong spermicidal and antiviral [anti-human immunodeficiency virus (HIV)-1] activity. The same effects are observed for F-5 Gel, the active mixture of a new contraceptive sponge (Protectaid), which contains sodium cholate in association with low concentrations (0.5%) of nonoxynol-9 and benzalkonium chloride. Both cholic acid and the F-5 Gel exert a dose-dependent, in-vitro inhibitory effect (i) on the activity of HIV-1 associated reverse transcriptase in an acellular system and (ii) on the potential of HIV-1 efficiently to infect human lymphocytes. During 12 months use, the contraceptive efficacy of the 'Protectaid' sponge was 100% in 20 young women who had chosen this method for reasons of both contraception and anti-sexually transmitted disease. No side-effects were recorded throughout this period. Cervical cultures at 6-month intervals showed the presence of Mycoplasma hominis and Candida albicans in one or two cases. The combined spermicidal and anti-HIV properties of cholic acid reported in this paper and used in the 'Protectaid' sponge offer a new and modern protective method of contraception.

Adult↗
PubMed1992

Endocrinological profile of oligomenorrheic strenuously exercising adolescents.

The endocrinological profile of 20 strenuously exercising oligomenorrheic adolescents divided into 2 groups (groups A and B), was correlated with that of 10 athletes (group C) with normal menstrual cycles and without strenuous exercise. Group A LH serum baseline values were found to be statistically significantly lower than those of group C (P less than 0.001). FSH/LH basic values were 1.9- and 2.9-times higher in group A athletes than those of group B or C (P less than 0.05 and P less than 0.001, respectively). 17 beta-estradiol (E2) and prolactin serum levels were found lower in group A and B athletes than those of group C (P less than 0.01-0.05). Dehydroepiandrosterone sulfate and delta 4 androstenedione serum levels were found lower in group A athletes than those of group C (P less than 0.001). The low LH and E2 values indicate the anovulatory status of group A and B cases which were also confirmed by ultrasound. It is concluded that no severe endocrinological changes exist in strenuously exercising oligomenorrheic athletes in relation to menarche.

Adolescent↗
PubMed1991

Combined GnRH-agonist and HMG therapy in patients with stimulation failure.

This study deals with the combined therapy of GnRH-agonist (GnRH-a) and HMG for stimulation in 15 patients who failed two prior in vitro fertilization attempts. Fifty-three patients who received HMG without GnRH-agonist suppression served as controls. Comparing the HMG group with GnRH-a/HMG cycles, the cancellation rate dropped from 35.5% to 13.2%. Oocyte recovery was similar in both groups, as were the fertilization rates, 88.4% in GnRH-a and 82% in HMG cycles, respectively. The number of embryos available for transfer was virtually identical in both groups (3.7 vs. 3.6). Embryo cleavage speed was higher in GnRH-a than in HMG regimens. The E2 rise was smooth in the GnRH-a group compared to the sharp rise observed in the HMG group. The pregnancy rate per transfer was 30.5% in the GnRH-a group versus 20.5% in the HMG group. GnRH-a seems to offer a clear improvement to a number of stimulation failures.

Adult↗
PubMed1991

Teenage pregnancy: comparison with two groups of older pregnant women.

To evaluate the risk of adolescent pregnancies, we examined three groups of primigravidae in a prospective study from 1987 to 1988. A special protocol for the evaluation and follow-up of adolescent pregnancies was made. The rate of adolescent pregnancies was found to be two times higher between the years 1985 and 1987-1988. The pregnancy complications seen in the adolescent patients were equal to or lower than those found in older women. The cesarean section rate was also found to be lower in adolescent pregnancies. We conclude that sexual education programs are necessary for the reduction of teenage pregnancies and adequate medical prenatal care, as well as psychologic and social support, must be given to avoid both medical and psychologic problems for the sensitive young mother.

Adolescent↗
PubMed1991

Outcome of ovarian response after suppression with a gonadotropin releasing hormone agonist in different chronological periods prior to gonadotropin stimulation for in vitro fertilization.

Gonadotropin-releasing hormone analogues (GnRH-a) are currently used in combination with gonadotropins in ovarian stimulation for in vitro fertilization programs (IVF). The present study aims at evaluating the treatment cycles for IVF for which human menopausal gonadotropin (HMG) was initiated only when pituitary desensitization was confirmed regardless of the time of GnRH-a administration. Two groups of patients were examined. Patients in group A (n = 46) were commenced with HMG treatment on day 15 when E2 level was less than 40 pg/ml. Group B patients (n = 27) comprised the cycle treatments in which E2 levels were greater than 40 pg/ml on day 15. In these cases HMG was first given when E2 levels declined to less than 40 pg/ml. The fertilization rate was similar in both A and B groups, 71.6 and 67.7% respectively. The pregnancy rate per transfer was 27.5 and 34.6% in group A and B respectively. Multiple pregnancies were found at 18.1% in group A versus 44.4% in group B. It is concluded that postponement of HMG administration in patients with high levels of E2 on day 15 after GnRH-a administration seems to offer an improvement in embryo cleavage speed, pregnancy rate and multiple pregnancies.

Adult↗